Doctors After the Fact

Blackbourne — white hair, white beard — scans a report in his hands and summarizes that “a 51-year-old guy, cardiac disabled who always drives on the right because of his heart condition — has congestive heart failure, severe coronary artery disease, two years ago had abdominal surgery for removal of blood clots — was south on I-805 in the far-right lane. Another driver witnesses him clutch his chest and drive off the road onto the vegetation. Apparently his mouth hit the steering wheel, because when they get him to the hospital they suction teeth out of his oral pharynx. X-ray finds another tooth in his pharynx, and they cleared a bunch of loose teeth from his jaw. They could not resuscitate him.

“Apparently anything that makes you a driving risk is reportable by the doctor. But how many people have angina and are driving all over town?”

“Or can’t see?” adds Davis. “When I was in ophthalmology clinic I was stunned. It’s just incredible the number of people who couldn’t see. They’d say, ‘You gotta hurry up ’cause I’m double-parked.’ ”

Dr. Leena K. Jariwala is an East Indian woman no more than five feet tall. From time to time she has made indiscernible soft comments in an accented voice.

“Sixteen-years-old Cambodian student here in the United States since 1983 and living with his family. Fourteenth March the decedent had been a passenger in a Jeep stopped in traffic near mid-span on the Coronado Bay Bridge and the vehicle contained several young persons who related the following to the police...”

Jariwala reads verbatim, but the gist is that the boy was arguing with his girlfriend who’d just announced their relationship was over...

“...as the Jeep came to a stop, the decedent said, ‘Now you will never see me again...’ He jumped out of the vehicle and jumped over the rail of the bridge. The other occupants of the Jeep ran over to the rail and looked into the water for the decedent, but they did not see him. He was found seven days later by a boater — a seriously decomposed young person, 3:00 p.m. on 3/20.”

Dr. Eisele shares a similar case. “Forty-one-year-old executive, divorced and severely depressed as a result of it. Car found abandoned on the bridge at the highest section of the bridge. They found the decedent floating in the water last night.”

Each step was a struggle for balance. A bloody slime on his hands had made the beam slippery, and flies had begun swirling and striking like mosquitos at his eyes and mouth and anywhere the slime had smeared. And the poncho intensified heat and accelerated decomposition until the odor of something freshly gutted had putrefied into something more liquid-like and sulphurous that coated his tongue and lined his nostrils. “God! he’s rotting inside!” Then the rope securing Boyer’s head came untied and the meat hit the ground with a whump of rubber unwrapping and a crash of beam thrown down and everyone turned ’round swearing as the one smeared stumbled away retching.

“You’re dealing with death. That’s our job. You deal with death. And grieving families. All day long. Every day. It is the toughest thing about this job.”

There is part of Calvin Vine — supervising medical examiner investigator — that rings a bell: the “former Navy corpsman” part. Where had he been stationed?

“Aboard the USS Sanctuary. Went aboard November of ’68 and got off December of ’69.”

Damn! So was I. Or rather, a seriously blown-up patient aboard June of ’69. For Vine, his connection between past and present — the dead in Vietnam to the dead in San Diego — is not astonishing.

“Seeing the death and the trauma there made it a lot easier for me. When I was a hospital corpsman, if any of our patients expired, I always went down and watched the autopsy to find out if we could’ve done anything to have prevented their death. In Vietnam you quite naturally had a young patient, and theoretically you’ve got the ‘golden hour’ — from time of trauma to hospital ship — when you should be able to save ’em. So we went to the autopsies. The field just started fascinating me at that point...studying death.”

Vine — a medium-sized man with a persistent half-smile — continued his Navy career until “I made so much in promotion I promoted myself right out of the field.” Retiring from the Navy eight years ago, Vine returned to San Diego and said to his wife, “ ‘I want to be an investigator,’ and I got hired within ten months. You have to go through psychological testing, psychiatric exams. They want to make sure that you’re stable enough, that you’re the type who can deal with death.

“There are things you see in this field that people associated with medicine never have seen before. They have no idea what a decomposed body looks like. I had seen a lot of burned humans in Vietnam from napalm, seen the fire strikes and everything, and it bothered me. It really did. And major trauma, you know, blown-apart bodies. But a decomposed body? A skeletonized body? There’s no training for it.

“You jump in one of these cars and go to a scene, and you may have a body that’s been dead for three weeks, three months — or three years. There’s nothing to prepare you for the odor when you walk in. Or the sight that you’re going to see. Doctors in the hospitals — they never see that kind of stuff. The first few times I had decomposed bodies and I’d go home, my wife would say, ‘Get out of here!’ She’d make me take my clothes off outside before she’d let me come in and jump in the shower.”